Provider Demographics
NPI:1225569130
Name:CHITTURI, KALYAN RAGHAVENDRA (DO)
Entity type:Individual
Prefix:
First Name:KALYAN
Middle Name:RAGHAVENDRA
Last Name:CHITTURI
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 W ARBOR CAMP CIR
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77389-5323
Mailing Address - Country:US
Mailing Address - Phone:740-877-0079
Mailing Address - Fax:
Practice Address - Street 1:13127 VAIL RIDGE DR
Practice Address - Street 2:
Practice Address - City:RIVERVIEW
Practice Address - State:FL
Practice Address - Zip Code:33579-7196
Practice Address - Country:US
Practice Address - Phone:813-661-6199
Practice Address - Fax:813-661-6334
Is Sole Proprietor?:No
Enumeration Date:2017-03-22
Last Update Date:2025-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXV7846207RI0011X
TX77846207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0011XAllopathic & Osteopathic PhysiciansInternal MedicineInterventional Cardiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease